The initial validation of an Evidence-informed, competency-based, Applied Compassion Training (EnACT) program: a multimethod study.

INTRODUCTION: Compassion is positively associated with improved patient outcomes, quality care ratings, and healthcare provider wellbeing. Supporting and cultivating healthcare providers' compassion through robust and meaningful educational initiatives has been impeded by a lack of conceptual clarity, inadequate content coverage across the domains of compassion, and the lack of validated evaluation tools. The EnACT program aims to address these gaps through an Evidence-informed, competency-based, Applied, Compassion Training program delivered to healthcare providers working in various clinical settings. In this study, we describe the development and initial validation of the program, which will inform and be further evaluated in a forthcoming Randomised Controlled feasibility Trial (RCfT). METHOD: A multimethod design was used to explore learner needs, experiences, and outcomes associated with the program. Pre- and post-training surveys and qualitative interviews (1 month post training) were conducted among twenty-six healthcare provider learners working in acute care and hospice. Quantitative measures assessed professional fulfillment/burnout, self-confidence in providing compassion, learner satisfaction, and compassion competence. Qualitative interviews explored learners' experiences of the program, integration of learnings into their professional practice, and program recommendations. RESULTS: Learners exhibited relatively high self-assessed compassion competence and professional fulfillment pre-training and low levels of burnout. Post-training, learners demonstrated high levels of compassion confidence and satisfaction with the training program. Despite high levels of reported compassion competence pre-training, a statistically significant increase in post-training compassion competence was noted. Thematic analysis identified five key themes associated with learners' overall experience of the training day and integration of the learnings and resources into their professional practice: (1) A beginner's mind: Learner baseline attitudes and assumptions about the necessity and feasibility of compassion training; (2) Learners' experiences of the training program; (3) Learner outcomes: integrating theory into practice; (4) Creating cultures of compassion; and (5) Learner feedback. CONCLUSION: Findings suggest that the EnACT program is a feasible, rigorous, and effective training program for enhancing healthcare provider compassion. Its evidence-based, patient-informed, clinically relevant content; interactive in class exercises; learner toolkit; along with its contextualized approach aimed at improving the clinical culture learners practice holds promise for sustaining learnings and clinical impact over time-which will be further evaluated in a Randomized Controlled feasibility Trial (RCfT).

Nursing students' experiences and perceptions of an innovative graduate level healthcare grand challenge course: a qualitative study.

Nursing leaders are increasingly required to create and implement innovative solutions to address challenges in the workplace. However, the present-day education of graduate nurses may not adequately prepare them for entrepreneurial approaches to problem solving required in today's complex healthcare environments. To fill this gap, we designed, implemented, and evaluated a Healthcare Grand Challenge course for graduate nurses interested in developing their leadership skills. Following the course, students were invited to participate in a qualitative research study to explore their experiences and perceptions of the course and identify how they used the knowledge and skills developed through the course in their leadership practices. This study provides key lessons for future offerings of grand challenge courses while highlighting the influence of grand challenge courses on current and future nursing leadership practice.

A grounded theory of clinical nurses' process of coping during COVID-19.

AIMS AND OBJECTIVES: To explore clinical nurses' process of coping during COVID-19 and develop a grounded theory that can be used by leaders to support clinical nurses during a disaster. BACKGROUND: The COVID-19 pandemic has provoked widespread disruption to clinical nurses' work. It is important to understand clinical nurses' processes of coping during disasters to support the nursing workforce during events such as global pandemics. DESIGN: We employed the Corbin and Strauss variant of grounded theory methodology, informed by symbolic interactionism, and applied the EQUATOR guidelines for qualitative research publication (COREQ). METHODS: Data collection entailed semi-structured interviews with experienced clinical nurses (n =20) across diverse settings. We analysed data by identifying key points in the nurses' coping processes inductively building concepts around these points. RESULTS: The predictor of nurses' outcomes in this grounded theory was their confidence in their ability to cope during the pandemic. When nurses lacked confidence, they experienced working in the context of acute COVID-a state of chaos and anxiety, with negative consequences for nurses. However, when nurses were confident in their abilities to cope with the pandemic, they experienced working in the context of chronic COVID, a calmer state of acceptance. There were many workplace factors that influenced nurses' confidence, including adequacy of personal protective equipment, clear information and guidance, supportive leadership, teamwork and adequate staffing. CONCLUSIONS: Understanding clinical nurses' experience of coping during COVID-19 is essential to maintain the nursing workforce during similar disasters. RELEVANCE TO CLINICAL PRACTICE: Nurse leaders can target areas that support nurses' confidence, such as adequate PPE and staffing. In turn, increased confidence enables clinical nurses to cope during disasters such as a global pandemic.

Students and simulation facilitators' experiences and perceptions of a distraction and interruption simulation: a mixed-methods study.

BACKGROUND: While distractions and interruptions are leading causes of errors during medication preparation, most nursing students are not taught how to manage distractions in a highly-interruptive environment. To help prepare nursing students to manage distractions and interruptions in clinical practice, we developed, implemented, and evaluated a medication preparation distraction and interruption simulation. OBJECTIVES: To explore student and simulation facilitators experiences and perceptions of a distraction and interruption simulation. DESIGN: A sequential explanatory mixed-methods design was adopted including surveys, interviews, and focus groups. SETTING: A mid-sized research intensive western Canadian university. PARTICIPANTS: A total of 112 third year nursing students who engaged in the distraction and interruption simulation, and five simulation facilitators who facilitated the distraction and interruption simulation, participated in this study. METHODS: Students were invited to complete a cross sectional survey following the distraction and interruption simulation and were then invited to participate in focus groups. Simulation facilitators were invited to participate in one-on-one interviews following facilitating the distraction and interruption simulation. All data were collected between June and December 2020. RESULTS: Data from surveys, interviews, and focus groups were delineated into 4 themes related to the phases of the simulation. The prebriefing provided an overview of the simulation and helped create psychological safety that was imperative for learning about potential medication errors when being distracted and interrupted. The simulation scenario had a high degree of fidelity and helped students implement strategies to manage distractions and interruptions. The structured debrief provided an opportunity for meaningful reflection. The impact of the simulation was apparent as students articulated the balance between speed versus safety and new strategies developed to manage distractions and interruptions in clinical practice. CONCLUSION: This study supports the use of simulation to develop key skills for managing distractions and interruptions during medication preparation in clinical practice.

Unemployment and labour market recovery policies.

Evidence shows long-term unemployment (LTU) can have life-long scarring impacts on the future employment and earning prospects of individuals and lead to an overall deterioration in the wellbeing of communities. This article examines long-term unemployment in India, providing some of the first estimates from a panel of individuals before and during the pandemic. It shows that LTU makes up a substantial proportion of unemployment among the working-age population, particularly among young workers who have fared even worse since the pandemic. Existing benefits have proven inadequate in addressing long-term unemployment and young workers have a strong desire for active labour market policies from the government to address the worklessness crisis. A national-level commitment to active labour market policies could prevent a lost generation of young workers from falling into long-term unemployment and the ills that accompany it.

A systematic review of online education initiatives to develop students remote caring skills and practices.

The ongoing COVID-19 pandemic has altered caring professions education and the range of technological competencies needed to thrive in today's digital economy. We aimed to identify the various technologies and design strategies being used to help students develop and translate professional caring competencies into remote working environments. Eight databases were systematically searched in February 2021 for relevant studies. Studies reporting on online learning strategies designed to prepare students to operate in emerging digital economies were included. Quality assessment was undertaken using the Effective Public Health Practice Project Quality Assessment Tool and/or the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Thirty-eight studies were included and synthesized to report on course details, including technologies being used and design strategies, and study outcomes including curriculum, barriers and facilitators to technology integration, impact on students, and impact on professional practice. Demonstrations of remote care, videoconferencing, online modules, and remote consultation with patients were the most common instructional methods. Audio/video conferencing and online learning systems were the most prevalent technologies used to support student learning. Students reported increased comfort and confidence when working with technology and planning and providing remote care to patients. While a recent influx in research related to online learning and caring technologies was noted, study quality remains variable. More emphasis on assessment, training, and research is required to support students in using digital technologies and developing interpersonal and technological skills required to work in remote settings.